Be Informed

Facial Aesthetic Surgery

Q:

I had a friend who had fat grafting in her face. Is this a popular procedure and if so why?

A:

According to a recent survey of Plastic Surgeons, facial fat grafting is increasing in popularity.

The practice of transplanting fat by injecting abdominal or other fat to fill out cheeks, creases and areas that are sagging has become more widely embraced by plastic surgeons in the past few years. According to results of a survey by NYU Langone Medical Center researchers, the process of fat grafting is gaining in popularity.

The American Society of Plastic Surgeons is the largest plastic surgery specialty group worldwide, and 309 randomly-selected members were asked to complete the survey.

Surgeons were asked about their methods of harvesting, processing, and injecting fat, the most commonly selected injection sites, and their opinions on the overall efficacy of grafting as a facelift procedure. They were also surveyed as to how often they used fat grafting in facelifts.

85 percent of the 309 facial aesthetic surgeons surveyed use fat grafting as a technique to enhance the results of facelift procedures designed to smooth wrinkles and creases, and eliminate sagging. Of this group, over 70 percent reported adopting the method within the past 10 years.

The survey results show that a majority of plastic surgeons across the country are adopting fat grafting as a standard technique to optimize the results of facelift procedures.

Researchers say the survey is believed to be the first of its kind to determine the frequency and extent of plastic surgeons’ use of the injectable fat-grafting method for facelifts. The survey results are summarized in the journal Plastic and Reconstructive Surgery.

As part of the survey, the ways in which plastic surgeons practice fat grafting were analyzed. The most popular sources of fat were from the patient’s abdomen (over 80 percent of the respondents’ cases) and from the hips (10 percent of cases). The amount of fat injected into the face to replace volume loss from aging ranged from 11 cubic centimeters to 25 cubic centimeters (about 3 to 5 teaspoons).

Surgeons typically add extra fat to compensate for the amount of fat likely to be reabsorbed by the body, about 40 percent of the initial injection. The rest remains indefinitely. By contrast, synthetic/commercial dermal fillers, an alternative to injected fat, last only nine months to a year and require repeated injections.

According to the survey group, the most commonly injected areas of the face are the cheek, the region below the lower eyelid, and the nasolabial folds, or creases between the nose and corners of the mouth.

Fat grafting is currently the only widely used method able to counter so-called volume deflation in the face, or loss of fat over time. The results of fat grafting procedures have improved dramatically in the past 10 years. Initial results were sometimes unpredictable and inconsistent. A deeper understanding of the facial anatomy in regards to fat compartments has led to refinements in fat grafting, along with more consistent and longer-lasting results. Reports of complications are rare.

Candidate for eyelid surgery?

Q:

Who is a good candidate for eyelid surgery?

A:

In general, good candidates for eyelid surgery are:

Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing

Non-smokers

Individuals with a positive outlook and specific goals in mind for eyelid surgery

Individuals without serious eye conditions

Excess skin and fine wrinkles of the lower eyelid

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Sometimes a drooping eyelid is caused by stretching of one of the upper eyelid muscles, the levator.

The board-certified plastic surgeons at Edina Plastic Surgery specialize in cosmetic procedures including blepharoplasty. We welcome you to come in for a free consultation.

They will evaluate your anatomy thoroughly to determine the causes of your eyelid appearance, and what procedures might best remedy them.

Eyelids are getting droopier?

Q:

I feel like my eyelids are getting droopier every day. What is a good solution?

A:

Eyelid surgery is one of the most popular types of plastic surgery procedures, and patients say they look more youthful and refreshed.

Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. This is a very popular procedure. In 2014, more than 200,000 blepharoplasties were performed in the United States.

A blepharoplasty can be performed on your upper eyelids, lower eyelids, or both. Based on a preoperative evaluation of factors such as your underlying facial muscle structure, bone structure, and the symmetry of your eyebrows, the surgeon will decide how much skin, muscle, and/or fat to remove.

“I was 51 years old when I had a blepharoplasty (eyelid surgery) at Edina Plastic Surgery. I was delighted with the very natural-looking results. I look more ‘awake and rested’ and it is more fun to apply eye makeup now that my eyes look so much more youthful. There was very little discomfort following the procedure. I have recommended this procedure and Edina Plastic Surgery to many friends of mine.”

Whether you want to improve your appearance or are experiencing functional problems with your eyelids, eyelid surgery can rejuvenate the area surrounding your eyes.

SPECIFICALLY, EYELID SURGERY CAN TREAT:

Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision

Excess fatty deposits that appear as puffiness in the eyelids

Bags under the eyes

Drooping lower eyelids that reveal white below the iris

Excess skin and fine wrinkles of the lower eyelid

Where else can Botox® be used?

Q:

I know that Botox® is very versatile; but besides the forehead where else can it be used?

A:

Botox® can be effective on many areas of the face, neck and even the upper chest.

LOWER EYELID:

The jelly roll area which is under some people’s eyelid area is another area where Botox® can be effective. This area is most evident when patients smile really big. When Botox® is injected into the middle of the lower eyelid it makes the eye look more open and youthful.

EYEBROW (LATERAL):

Botox® can be injected to reduce eyelid hooding to produce some of the benefits of a lateral brow lift.

CORNERS OF THE MOUTH/MARIONETTE LINES:

As some people age the corners of their mouths become downturned, giving them a “crabby look”. We can inject Botox® to relax the muscles and help make the corners more upturned. Patients can achieve a look that is friendlier and more approachable.

CHIN:

To reduce dimpling or “orange peel skin” on the chin, Botox® can be effective. It relaxes the muscle in the chin to help diminish the dimply look.

NECK (VERTICAL BANDS):

Botox® is also used in the neck to treat the vertical platysmal bands. These bands may become prominent as we age because the skin progressively loses elasticity and soft tissue support weakens. Botox® injections help to make these bands and lines less pronounced.

DECOLLETAGE:

We use Botox® in the décollete area to diminish the fine wrinkling.

Facelifts for Men

Q:

Are facelifts for men a rising trend?

A:

One of the latest trends in plastic surgery is that a record number of men are getting on board and telling plastic surgeons that they want a facelift, seeking the benefits that the procedure can offer.

In today’s culture, youth and appearance are equated with success for both women and for men. Facelift procedures are very common in the world of cosmetic surgery. They have historically been popular with women who want to look and feel younger and more refreshed.
According to The American Society for Aesthetic Plastic Surgery, in the past five years there has been a dramatic 43% increase in the number of nonsurgical and surgical cosmetic procedures for men. Starting in 1997, when the organization began collecting statistical data, the increase in the number of procedures performed on men has risen by a whopping 273%.

Many men look at cosmetic procedures as a way to gain confidence and enhance their careers. In a marketplace where looking fit, younger, and more masculine is imperative, the better you look, the better your chances of climbing the corporate ladder.

“The best facelifts for men are the ones that look very natural and distinguished,” says board certified plastic surgeon Dr. Robert Wilke.

“Many men consider that the investment they make on a facelift is good for business. They are successful and feel young and confident but may be worried that they don’t look that way. We can help them look more refreshed and extremely natural.”

A facelift can also include a neck lift, eyelift, jawline recontouring, and possibly liposuction. It is not just older men who are opting for cosmetic surgery. Many younger men who want to refresh their appearance are opting to get rid of unwanted wrinkles, bags under the eyes, drooping eyelids and double chins. Rhinoplasty is still the top cosmetic surgical procedure for men.

HydraFacial™ for winter weather

Q:

The skin on my face gets so dry in the winter months. What is a good professional moisturizing treatment?

A:

Winter is on its way. Along with the cold temperatures and wind, it also brings seasonal problems such as skin dryness and irritation. Cold temperatures can create poor blood circulation with widened capillaries and as a result, the skin suffers. However, the drop in temperature isn’t solely responsible for these issues. The drop in humidity and the use of indoor heating systems are also culprits in making the sky feel dry.

Our $180 HydraFacial treatment is a non-invasive, liquid skin resurfacing system with no downtime. It instantaneously hydrates the skin, helping you achieve smooth, well-cleansed, hydrated, moisturized skin in a matter of minutes.

The HydraFacial resurfacing procedure addresses all aspects of your skin’s health. It is the trifecta of effective facial treatments that combines the following:

The exfoliation and resurfacing of microdermabrasion;

The skin renewal of a chemical peel; and

The hydration and extractions of a deep-cleansing facial.

This is the ideal treatment before a big event because it improves clarity, color, and skin texture while tightening the skin, creating an overall youthful, fresh look. The HydraFacial procedure is soothing, moisturizing, non-irritating and is immediately effective.

LED Light Therapy—Light therapy provides additional benefits after the HydraFacial treatment. LED light therapy uses specific types of light, which give off energy that stimulates your cells, thereby increasing your skin’s production of collagen and elastin. In turn, your skin becomes firmer, less wrinkled and younger looking. The treatment’s red LED light helps improve the appearance of skin firmness and resilience, while reducing the appearance of fine lines and wrinkles, hyperpigmentation and other signs of aging. The blue LED light is extremely beneficial for people who suffer from oily skin or breakouts. And the combination of red and blue LED lights is helpful in reducing the appearance of rosacea.

Plastic surgery for people over 50?

Q:

Is plastic surgery becoming more of an accepted practice for people over 50 years of age?

A:

Seniors are turning to plastic surgery in record numbers. It may be a current trend for the “more mature” to let their hair color go to a natural silver, but those same seniors are clamoring to have plastic surgeons erase other marks of aging like sagging breasts, wrinkles and droopy eyelids.

No matter how hard they look, these men and women know that there are no creams, potions or drugstore remedies that can completely erase the effects of aging. There is no such thing as an over-the-counter miracle cure. The former head of Revlon, Charles Revson was quoted as saying “I am selling hope in a jar.” Today older Americans are often finding that hope is in the hands of board-certified plastic surgeons.

A record number of senior citizens are electing to undergo plastic surgery. In 2014, women and men from the ages of 51 – 64 accounted for 25% of the surgical and 32.9 percent of the non-surgical cosmetic procedures. The total of those procedures for the year was more than 10 million. Add to that the number of people 65 and over who made up 8% of the total of yearly surgeries and 11% of the non-surgical procedures and you have got some very significant numbers of people over the age of 50 opting for cosmetic procedures. And the numbers are increasing every year, so the trend is clearly growing.

It’s not that hard to answer the question “Why are cosmetic procedures becoming more popular for people 50 and older?” Medical technologies are ever-advancing. This means that people are living longer and living more healthy lifestyles. They feel good and they want to look just as good as they feel.

If they are still in the work environment these patients often feel the pressures of the work environment and want to “continue to fit in”. Many have returned to the dating world and want to look their best to meet new people.

When asked about this trend, Dr. Robert Wilke, a plastic surgeon board certified by The American Board of Plastic Surgery said, “Every year we see more patients that are over 50, and the over-65 patient base is growing as well. My partners and I perform procedures that make people look and feel more youthful, but in a very natural way. Most people want a natural looking result. They still want to look like themselves, just a more refreshed and rejuvenated version of themselves.” The surgeons at Edina Plastic Surgery are experts in performing these procedures, as evidenced by all three of them being named as Top Doctors.

Seniors are asking for all types of surgeries and cosmetic procedures, but the most commonly requested surgeries are: facelifts, eyelid lifts, breast lift, tummy tucks and liposuction. These are followed in popularity by breast augmentation, breast reduction, lower body lifts and forehead lifts.

Do the risks increase as the age does?

“Many people are under the impression that advanced age automatically increases the surgical risk for patients,” says Dr. Wilke, “but that is not necessarily the case. Age does not have to be a limitation, but any co-morbidities and extenuating medical conditions that the patients are experiencing can play a part as to whether they are a good candidate for plastic surgery. Every patient needs a full medical evaluation preoperatively, and we, along with their primary physician, need to assess their surgical risk to determine if elective surgery is appropriate for them.”

Dr. Wilke goes on to say, “Because of advances in medical technology and techniques, plastic surgery is not only safer than ever, the results are better than ever as well. With our refinements in surgical techniques, as well as better and safer anesthesia, it all adds up to make it easier for these more mature patients to enjoy the benefits of plastic surgery.”

And with social mores and opinions on plastic surgery becoming more accepting, the social stigma of having “something done” has been all but erased. Surgeries are no longer considered a mark of vanity and they are no longer limited to Hollywood divas and jet-setting executives. The vast majority of people electing to have procedures are middle class wage earners who have saved up to get plastic surgery because it is important to them.

Looking more youthful with non-surgical alternatives.

For the maturing population who want to avoid or postpone a surgical option, the non-surgical alternatives are also very popular. Seniors are flocking to the offices of plastic surgeons and to skin clinics for all kinds of treatments including Botox® to erase wrinkles and facial fillers to plump up hands and face. They are also trying skin rejuvenation in record numbers. These include chemical peels, dermabrasion, skin-tightening lasers and laser skin resurfacing.

“At Edina Plastic Surgery we have a great skin clinic,” says Dr. Wilke. “So our patients have the option of any type of surgical or non-surgical procedure in their pursuit of looking more youthful. As people go through life transitions they want to look good; and no matter what avenue they choose we are there to help them reach their goals.”

Tips Pre-Facelift

Q:

Are there tips for patients to do pre-procedure when having a facelift?

A:

The surgeons at Edina Plastic Surgery know that the best results from any facial plastic surgery procedure look extremely natural. The facelifts we perform do not look “fake”, but are done so well that others really don’t notice. The most common responses that our patients receive are; “Did you get a new hairstyle?” or simply “You look so good!”

A good recommendation for patients that don’t want to call attention to the results of their facelift is to change their hairstyle or hair color before their procedure. This way people commenting on how great they look often refer to the hairstyle change.

Plastic Surgery in the Cold Months

Q:

Friends have said that the cold weather months are great for having plastic surgery procedures; why is that?

A:

Just like there are good seasons for sporting activities there are seasons that can greatly benefit patients considering plastic surgery procedures. The cold months of winter/early spring can have their benefits

The months from February through April can be the ideal time to undergo just about any type of cosmetic surgery from facelifts to breast augmentations to tummy tucks and liposuction.

There is less direct sunlight during these months which is advantageous when having any facial cosmetic surgery or laser treatments.

Turtlenecks, scarves and hats can help hide the temporary bruising/discoloration from a facelift, laser resurfacing or brow/eyelid lift.

The cooler weather allows patients to conceal any temporary swelling/bruising or bandages with seasonally appropriate bulky clothing such as heavy sweaters and winter weight slacks.

Many patients find it easier to “take it easy” after a surgery during the colder months when most everyone tends to be less active.

Usually the months immediately after the holidays are simply “less social” so there are fewer events to be missed with post-surgery downtime.

Liquid Facelift

Q:

What is a “liquid facelift” and how effective is it in making people look more youthful?

A:

Our nurse injectors soften lines with Botox® and add back youthful volume with fillers like Voluma® XC. By using a combination of injectable fillers and/or muscle immobilizing products, lines can be minimized or erased, and sagging skin lifted and filled out.

Patients can see noticeable improvements from these liquid facelifts without the downtime of surgery. Middle-aged people who have mild jowls, volume loss, vertical lip lines, crow’s feet, lines along the side of the nose and chin — sometimes called marionette lines — can benefit greatly. Also, injectable products can correct asymmetries and even those bands in the neck below the chin that become prominent with age.

It is important to note that a “liquid facelift” is not permanent and must be repeated every few months with shorter-acting products, or every couple of years with more long-lasting products. The goal is to make patients look “better” and not “different” and our nurse injectors are experts in achieving these results.